State revokes mental health center's license after suicides

December 10, 2011

Regulators found fault with staff at Annandale IRT ["intensive residential treatment], where two residents committed suicide in the past year.

State regulators have revoked the license of an Annandale mental health treatment facility that failed to properly care for two residents who committed suicide in the past year.

In one case, workers failed to immediately try reviving a resident found hanging from a closet door with a jump rope around the neck. In another case, workers failed to take steps to protect a suicidal resident.

The deaths occurred at Annandale IRT, which has been repeatedly cited for violating rules aimed at protecting its vulnerable clients over the past two years, according to an investigative report issued Monday by the Minnesota Department of Human Services.

The 16-bed facility has 10 days to appeal the revocation.

“We believe the service they are providing is substandard,” DHS Inspector General Jerry Kerber said.

In a December 2010 incident, three workers failed to immediately remove the rope from the resident’s neck or provide CPR in a timely manner after discovering the suicide, according to the state report. Family members had previously complained about the level of care at the facility. One later told state investigators that family members were concerned that the resident had been allowed to keep a jump rope in their room.

About a month later, another resident at Annandale IRT committed suicide. In that case, a family member “begged” the facility to take immediate action because the resident was distraught and planning suicide, the report said.

“The staff persons told the (family member) that they were ‘equipped’ to handle this situation and the (resident) did not need to go to the hospital,” the report said.

The resident, who suffered flashbacks from sexual and physical abuse, committed suicide by hanging later the same day, using a scarf tied to the door handle of a bedroom. The resident had tried suicide before and suffered from major depression and post-traumatic stress, according to the report.

The state did not identify either suicide victim.

The deaths were “truly unfortunate,” said David Baraga, executive director of Central Minnesota Mental Health Center, which operates the facility and other mental health and chemical dependency centers in a four-county area near St. Cloud.

The Annandale facility has undergone major personnel changes in the past 10 months, including new leadership, Baraga said. He said the non-profit organization will appeal the revocation order.

If the appeal fails, the three-year-old facility will have to shut down, he said. “We’re working on the citations they gave us and feel we’re well on the way to satisfying them,” Baraga said.

Since 2009, the facility has been cited for more than 40 licensing violations, state records show, and about half of those violations were repeat offenses. The facility was ordered to pay a total of $1,400 in fines.

Source: Brad Schrade, "State revokes mental health center's license after suicides," Star Tribune, October 11, 2011.